Medical Video Game Guru: Interview with Sam Glassenberg, Level Ex CEO

Sam Glassenberg has spent his career in the video game industry, and now is on a mission to bring the leading edge of video game technology into healthcare. Sam is the founder and CEO of Level Ex, an award winning company making professional video games for doctors. Before Level Ex, Sam was CEO of a leading independent game publisher in Hollywood, led the DirectX team at Microsoft, and has been pushing limits in the gaming industry. Sam has an M.S. in Computer Science and Graphics from Stanford University, and a B.S. in Computer Engineering from the University of Illinois. I met Sam at the recently concluded TEDMED 2018 and spoke with him about his company and the direction they are headed.

Tom Fowler, Medgadget: What is your favorite video game of all time? (excluding Level Ex games of course)

Sam Glassenberg: It’s a toss-up between Duke Nukem 3D (1996) and Half-Life 2 (2004). Both of these games introduced revolutionary graphics technologies, physics-based gameplay, storytelling techniques, and most importantly – raised the bar for interactable environments. The world of Duke Nukem really came to life – it felt as though you could interact with almost any element in the urban environment, which was unheard of in 1996. Half-Life 2 had breathtaking graphics and artwork for the time. Most importantly, its in-game physics were sophisticated enough to enable groundbreaking physics-based gameplay in the genre. It was the first-person-shooter to have complex puzzles that required you to manipulate objects in the scene the right way to achieve the goal – combining rigid objects, water, forces, and other physical elements. My favorite game in the last few years is Mushroom 11. It’s a physics puzzler that was actually designed by our Lead Game Designer at Level Ex before he joined us. I’m not the only one with that opinion – it won an Apple Design Award and Google Play Independent Game of the Year in 2017.

Medgadget: When did you first get interested in expanding your video gaming interests into healthcare?

Sam Glassenberg: The whole thing happened by accident in 2012.

I’ve enjoyed an exciting and impactful career in the video games industry animating Star Wars cutscenes at LucasArts/LucasFilm and managing teams at Microsoft and elsewhere.

I come from a long line of doctors – my grandfather, both my parents, uncles, and my wife. I was the black sheep of the family that didn’t go to medical school.

Back in 2012, my father, who is an anesthesiologist at Northwestern in Chicago, asked me to put all this “video game nonsense” to good use and build him a fiberoptic intubation simulator for his colleagues and residents. “I don’t want to drag anyone to the sim center,” he said. “Make me something that’ll run on their iPads.”

Two years later he called me up and asked, “How many people downloaded that thing?” “I have no idea,” I responded. “Let me check.”

So I did. We had 100,000 downloads from doctors, nurses, and EMTs worldwide. At that point, I googled it and they had done efficacy studies on it that showed it improved physician performance. Clearly, this was fulfilling a major unmet need in the medical community.

In 2016, I decided to assemble a team of top video game artists, engineers, and designers – along with top physicians in their field and leaders from digital health to build mobile and VR video games for physicians, now becoming a go-to virtual patient platform that allows them to overcome clinical challenges they face in medical practice, learn new approaches and techniques, and keep up to speed on medical device and pharmaceutical products – all in the framework of an entertaining video game.

Medgadget: What was the biggest design hurdle transitioning from creating entertainment oriented games to medically accurate simulations?

Sam Glassenberg: Our company doesn’t have to make this compromise when creating our games. Our team of game designers, who have decades of experience making games across a number of genres [played by 100s of millions of users], are skilled at applying proven game design principles from entertainment-based games to our physician video games. They know how to capture the thrill and challenge of practicing medicine from first-person perspective surgical scenarios to complex diagnosis puzzles that translates to an engaging and fun experience for the physician, especially when you present competitive design mechanics like scoring, time limits and leaderboards.

Medgadget: Do you foresee Level Ex expanding to mannequins and simulation hardware?

Sam Glassenberg: No; I don’t see us heading in that direction. There’s an ecosystem out there already of companies selling simulators and mannequins into hospitals. Unfortunately, only a fraction of medical professionals can even access this ecosystem since these tools are locked away in a few hundred simulation centers or inconsistently used across hospitals due to cost, lack of realism, and/or limited use cases. We’ve found that our ability to deliver our high bar of realistic content on mobile gives us the ability to impact the practice of medicine at scale (we’ve already crossed 300,000 medical professionals in just a year).

Medgadget: If I gave you $ 1 billion to develop a product of any kind, what would you create?

Sam Glassenberg: In short: I’d fix EHRs.

Transitioning from a career in video games to healthcare has been a sequence of what I’d call, for lack of a better term, “face-palm-able” moments. Moments where we realize how gruesomely far behind-the-curve healthcare can be relative to other industries. To their credit, healthcare folks readily admit this and share their frustration.

Coming from video games, we are constantly uncovering the challenges doctors face in learning new techniques. The stories all follow the same arc, with a climax that’s some variation of: “Wait a minute – we solved that problem over a decade ago in the games industry!”.

At Level Ex, we’re solving the problem for physician training – which is an important step in improving both patient outcomes and physician job satisfaction.

What is even more crushing to physician job satisfaction? EHRs.

When I order a Lyft on my phone, the user interface has been tuned and optimized to the point that I literally have to move one finger the minimal possible distance with the fewest number of taps to order a car.

My wife’s a pediatrician. At night, I watch her type and click endlessly for hours into her EHR. Typing the same things – over and over again. Dragging her mouse for miles in a slow, unwieldy interface that looks straight out of 1991. She’s literally doing it right now as I type up the answer to this question.

This is someone who has spent a substantial percentage of her life, at considerable expense, learning how to be a doctor. I shudder to think of the billions of dollars wasted as specialists are relegated to data entry, not to mention the immeasurable cost of the resulting attrition.

Facebook, Google, Uber, Grubhub, Siri, video games – we’ve solved these UX and data entry problems many times over. With $ 1B I’d unleash that on EHRs and disrupt that entire industry.